Why patients attend emergency department for primary care type problems: views of healthcare providers working in a remote community

Fatima, Yaqoot, Hays, Richard, Neilson, Anne, Knight, Sabina, and Jatrana, Santosh (2022) Why patients attend emergency department for primary care type problems: views of healthcare providers working in a remote community. Rural and Remote Health, 22 (1). 7054.

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Abstract

Introduction: Emergency department (ED) utilisation continues to increase, particularly for primary care presentations that do not require high level ED services. The reasons for this are complex, and research has focused on patient perspectives in choosing where to seek care rather than those of ED and general practitioner (GP) providers. This study aimed to address this gap by exploring the views of ED and GP providers regarding ED utilisation for primary care type health conditions in a small, remote Australian city with perhaps unique population demographics and service configuration.

Methods: Service providers from the ED and general practice clinics were invited to participate in focus groups and semi-structured interviews exploring their views on ED utilisation for primary-care-type health presentations. The data were analysed using thematic content analysis.

Results: In total, 24 healthcare providers (five GPs, seven ED practitioners, seven community nurse navigators, four Aboriginal and Torres Strait Islander Health Workers and one Indigenous Liaison Officer) participated in focus groups discussion and interviews. The analysis identified three themes: access and logistic barriers, rational decision-making and self-perceived urgency. While there was some overlap in the healthcare providers’ perceptions, there were also strong differences between ED and GP groups. In particular, the ED group believed that GP services are less accessible for urgent appointments, whereas GPs believed that such arrangements were in place. Both groups agreed on the need for clear communication between the ED and general practice.

Conclusion: ED and GP providers demonstrate similarities and differences in understanding patients’ reasons for choosing which service to access. The differences may stem from ED providers’ focus on offering a rapid resolution of acute presentations and GP providers’ focus on offering comprehensive and continuing care. Effective communication between general practice and the ED services and clearer referral pathways may help in reducing ED utilisation for less urgent primary-care-type problems.

Item ID: 72662
Item Type: Article (Research - C1)
ISSN: 1445-6354
Keywords: primary care services, remote emergency department, health services, service delivery, emergency department utilisation
Copyright Information: This work is licensed under a Creative Commons Attribution 4.0 International Licence
Date Deposited: 28 Feb 2022 06:57
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420321 Rural and remote health services @ 50%
42 HEALTH SCIENCES > 4202 Epidemiology > 420210 Social epidemiology @ 50%
SEO Codes: 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280123 Expanding knowledge in human society @ 50%
28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280112 Expanding knowledge in the health sciences @ 50%
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